Individual
GAUTHAM GANESAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 W 14TH ST # HA-6063, INDIANAPOLIS, IN 46202-2369
(317) 274-4343
Mailing address
350 W 14TH ST # HA-6063, INDIANAPOLIS, IN 46202-2369
(317) 274-4343
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11024630A
IN
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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